HARDWARE REQUEST FORM

Please note that you must have approval from your Department PRIOR to filling out this form.

Faculty/staff monitor purchases for telecommuting will not be approved. If the purchase is not a monitor replacement for an office on campus, only monitors purchased with external funding (i.e. grants) will be approved.

Please note that the standard approved monitor request from the college is a single 24" monitor.

First Name *

Last Name *

Email Address *

Campus Building and Room Number *

Will this upgrade or replace an exisiting machine? * Yes No

If upgrade or replacement, please provide serial number or service tag of the exisiting item

Model number and serial number or service tag

Departmental Approval * Yes No

Is the purchase to be made using grant funding? * Yes No

If grant funded, provide justification of how this purchase is required for the grant’s research goals.

Your request may be delayed or rejected if no justification is provided.

Department *

Chair/Program Director Email Address *

Index

Account *

Please describe each piece of equipment or parts being requested. *

Please indicate number of items.

Would you like consultation on your purchase? * Yes No

Upload

If you have documentation in regards to your request, system specifications, quotes, etc. You may upload it here.

Additional Upload 1

Additional Upload 2